TY - JOUR
T1 - Diagnosis of tuberculosis in South African children with a T cell-based assay: a prospective cohort study
AU - Liebeschuetz, S
AU - Bamber, S
AU - Ewer, K
AU - Deeks, Jonathan
AU - Pathan, A
AU - Lalvani, A
PY - 2004/12/31
Y1 - 2004/12/31
N2 - BACKGROUND: Childhood tuberculosis often presents non-specifically and is a common differential diagnosis in high prevalence areas. Current diagnostic tools have poor sensitivity and cannot reliably exclude tuberculosis, so overdiagnosis is common. HIV co-infection exacerbates this problem and accounts for an increasing proportion of paediatric tuberculosis worldwide. METHODS: We assessed the usefulness of a T-cell-based rapid blood test for Mycobacterium tuberculosis infection, the enzyme-linked immunospot assay (ELISPOT), in routine clinical practice. We did a prospective blinded study of 293 African children with suspected tuberculosis in kwaZulu-Natal, a region with high HIV prevalence. Children had full clinical assessment, ELISPOT, and a tuberculin skin test. Test results were compared with final clinical and microbiological diagnoses. RESULTS: In children with tuberculosis, sensitivity of ELISPOT was 83% (95% CI 75-89, n=133), significantly higher (p
AB - BACKGROUND: Childhood tuberculosis often presents non-specifically and is a common differential diagnosis in high prevalence areas. Current diagnostic tools have poor sensitivity and cannot reliably exclude tuberculosis, so overdiagnosis is common. HIV co-infection exacerbates this problem and accounts for an increasing proportion of paediatric tuberculosis worldwide. METHODS: We assessed the usefulness of a T-cell-based rapid blood test for Mycobacterium tuberculosis infection, the enzyme-linked immunospot assay (ELISPOT), in routine clinical practice. We did a prospective blinded study of 293 African children with suspected tuberculosis in kwaZulu-Natal, a region with high HIV prevalence. Children had full clinical assessment, ELISPOT, and a tuberculin skin test. Test results were compared with final clinical and microbiological diagnoses. RESULTS: In children with tuberculosis, sensitivity of ELISPOT was 83% (95% CI 75-89, n=133), significantly higher (p
U2 - 10.1016/S0140-6736(04)17592-2
DO - 10.1016/S0140-6736(04)17592-2
M3 - Article
C2 - 15610806
SN - 1474-547X
VL - 364
SP - 2196
EP - 2203
JO - Lancet
JF - Lancet
IS - 9452
ER -